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Changing trends in clinical characteristics and antibiotic susceptibility of K. pneumoniae bacteremia

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Author(s)
Chang In NohSeong Yeol Ryuand Hyun Ah KimMiri Hyun
Keimyung Author(s)
Ryu, Seong YeolKim, Hyun Ah
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Journal of Internal Medicine
Issued Date
2018
Volume
33
Issue
3
Keyword
BacteremiaDrug resistanceKlebsiella pneumoniae
Abstract
BACKGROUND/AIMS:

Klebsiella pneumoniae is second most common organism of gram-negative bacteremia in Korea and one of the most common cause of urinary tract infection, and intra-abdominal infection.

METHODS:

We compared clinical and microbiological characteristics about K. pneumoniae bacteremia in a tertiary hospital between 10 years. Group A is who had K. pneumoniae bacteremia at least one time from January 2004 to December 2005. Group B is from January 2012 to December 2013. We also analyzed antibiotic resistance, clinical manifestation of the K. pneumoniae bacteremia divided into community-acquired infections, healthcare associated infections, and nosocomial infections.

RESULTS:

The resistance for ampicillin, aztreonam, cefazolin, and cefotaxime significantly increased compared to 10 years ago. Extended spectrum β-lactamase positivity surged from 4.3% to 19.6%. Ten years ago, 1st, 2nd cephalosporin, and aminoglycoside were used more as empirical antibiotics. But these days, empirical antibiotics were broad spectrum such as 3rd and 4th cephalosporin. In treatment outcome, acute kidney injury decreased from 47.5% to 28.7%, and mortality decreased from 48.9% to 33.2%. In community-acquired infections, there was similar in antimicrobial resistance and mortality. In healthcare-associated and nosocomial infections, there was significantly increasing in antibiotic resistance, decreasing in mortality, and acute kidney injury.

CONCLUSIONS:

In community-acquired infections, broader antibiotics were more used than 10 years ago despite of similar antimicrobial resistance. When K. pneumoniae bacteremia is suspected, we recommend to use the narrow spectrum antibiotics as initial therapy if there are no healthcare-associated risk factors, because the antibiotic resistance is similar to 10 years ago in community-acquired infections.
Keimyung Author(s)(Kor)
류성열
김현아
Publisher
School of Medicine (의과대학)
Citation
Chang In Noh et al. (2018). Changing trends in clinical characteristics and antibiotic susceptibility of K. pneumoniae bacteremia. Korean Journal of Internal Medicine, 33(3), 595–603. doi: 10.3904/kjim.2015.257
Type
Article
ISSN
1226-3303
DOI
10.3904/kjim.2015.257
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41110
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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